Pain: The science and culture of why we hurt

page updated December 22 2015

summary

Marni Jackson’s book is probably the perfect book for thoughtful, liberal, middle-aged women in pain. Others may find it frustrating, overtly poetical and coquettish, neither rigorous enough for the science-minded, nor explanatory enough for the layperson seeking a better understanding of either “the science or the culture of why we hurt.”

Pain certainly does offer many interesting and creatively presented perspectives on pain: historical gee whiz facts, nuggets of science, and seemingly endless miscellany, curiosities and anecdotes from the subject.

Jackson’s thesis never coalesces — unless her thesis is that pain is hard to define or explain. On almost every page of her book, Jackson calls for a more nuanced definition of pain, and bemoans the failure of medical science to place pain in a cultural context. Unfortunately, after a few chapters of artful and entertaining meandering, it becomes clear that whatever greater definition there might be of pain, Marni Jackson is not writer enough to supply it. The reader is left agreeing but unsatisfied.

Again and again Jackson tells us that pain is not “just” the Cartesian cliché, that it is more than just a signal from insulted tissues, but Jackson never tells us: more what? Other than constantly cribbing from the great pain neurologist V.S. Ramachandran — that the mind is involved, that “pain is an opinion” — Jackson seems unable to say what pain is, only what it is now understood not to be. But this is a well-answered question and has been for some time (see Pain is Weird).

Still, most of this probably won’t (and shouldn’t) concern readers less curmudgeonly than myself. And, to be fair, Jackson undoubtedly fails simply because everyone else has — it really is a fiendishly difficult subject to talk about. As with any phenomenon that gets too tangled up in “the mind,” science simply does not yet have the relevant vocabularly. Trying to discuss the True Meaning of Pain in the early 21st Century is like talking about quantum physics before Einstein. We are probably at least two or three scientific paradigms away from some good answers on this subject.

A final word of warning: Jackon’s chapter about her sister’s bout of acute back pain is pretty much overflowing with amateurish misconceptions and contradictions. Even after quoting sensible back pain experts warning against the conventional wisdom in previous chapters, she still charges carelessly ahead and puts her stamp of approval on several chestnuts of erroneus but popular back pain faith. Only at the end of the chapter does she redeem herself somewhat with a few more level-headed assertions about back pain, namely that bed rest is not supported by the evidence, and most back pain heals regardless of what you do. Otherwise, the chapter is just the usual back pain nonsense.